可能肌少症人群吞咽功能变化特征及吞咽功能指标的筛查价值研究

关键词：可能肌少症  老年人群  吞咽功能  舌压  口腔咬合力

Keywords:possible sarcopenia  elderly population  swallowing function  tongue pressure  occlusal force

摘要：

      摘要 目的：基于2019年亚洲肌少症工作组提出的“可能肌少症”新定义，对江苏省内三个地区社区老年人群进行筛查，探究老年人群吞咽功能变化特征及吞咽功能指标对可能肌少症的筛查价值。 方法：根据2019年亚洲肌少症工作组提出的可能肌少症诊断标准，将社区2802例老年人分为可能肌少症组和非可能肌少症组。采用电子握力计测量受试者握力峰值，使用可系于腰间的步行记录穿戴设备测量受试者的步速和5次坐起试验时间，使用进食评估问卷调查工具（eating assessment tool-10，EAT-10）、100ml水吞咽试验、舌压和咬合力测试仪测量基本吞咽情况、吞咽速度、舌压峰值和咬合力峰值，建立数据库，采用SPSS 25.0软件进行统计分析。 结果：①可能肌少症者1087例（38.8%），男性617例（39.8%），女性470例（37.6%），男女患病率无显著差异。②男性、女性可能肌少症组100ml水吞咽速度、舌压峰值、咬合力峰值显著低于非可能肌少症组。③可能肌少症男性及女性组的100ml水吞咽速度与握力峰值、步速呈正相关，与5次坐起试验时间呈负相关。④可能肌少症男性及女性组舌压峰值与握力峰值均呈正相关，女性组舌压峰值还与5次坐起试验时间呈负相关。⑤可能肌少症男性及女性组咬合力峰值均与握力峰值呈正相关、与5次坐起试验时间呈负相关，而男性组咬合力峰值还与步速呈正相关。 结论：可能肌少症人群100ml水吞咽速度、舌压峰值、咬合力峰值均显著低于非可能肌少症人群，且100ml水吞咽速度、舌压及咬合力峰值等吞咽功能评估指标与可能肌少症诊断指标存在显著相关性，对可能肌少症人群进行吞咽功能的早期评估和吞咽肌功能训练，可预防其吞咽能力的进一步下降。

Abstract:

      Abstract Objective： To investigate the characteristics of swallowing function and its screening value for possible sarcopenia in the elderly population of communities in Jiangsu Province based on the new definition of "possible sarcopenia" proposed by the Asian sarcopenia working group in 2019. Method： According to the diagnostic criteria of possible sarcopenia proposed by the Asian sarcopenia working group in 2019， 2802 elderly people in the community were divided into possible sarcopenia group and non-possible sarcopenia group. The peak grip strength（GS） was measured using an electronic grip strength meter. Participants' gait speed and time for 5-time chair stand test were measured using wearable devices attached at the waist. Basic swallowing conditions， swallowing speed， peak tongue pressure， and peak occlusal force were assessed using eating assessment tool-10， 100ml water swallowing test， tongue pressure measurement device， and occlusal force measurement device. Establish a database and conduct statistical analysis using SPSS 25. Result： A total of 1087 participants were diagnosed with possible sarcopenia， 617 were male （39.8%）， and 470 were female （37.6%）. There was no significant difference in the prevalence rate between men and women. Both male and female groups with possible sarcopenia showed significantly lower swallowing speed， tongue pressure peak， and occlusal force peak compared to the non-possible sarcopenia group. In both groups with possible sarcopenia， the 100ml water swallowing speed was positively correlated with grip strength， walking speed， and negatively correlated with the time of 5-time chair stand test. The peak tongue pressure in males and females with possible sarcopenia was positively correlated with grip strength， and in females， it was negatively correlated with the time of 5-time chair stand test. The peak occlusal force in males and females with possible sarcopenia was positively correlated with grip strength and negatively correlated with the time of 5-time chair stand test， and in males， the peak occlusal force was also positively correlated with walking speed. Conclusion： Individuals with possible sarcopenia exhibit significantly lower 100ml water swallowing speed, peak tongue pressure, and peak occlusal force compared to those without possible sarcopenia. These swallowing function indicators are significantly associated with diagnostic markers of sarcopenia. Early assessment of swallowing function and targeted training of swallowing muscles may help prevent further decline in swallowing ability in individuals with possible sarcopenia.